SLOfit: Slovenia’s game changer to improve children’s health and wellbeing

Imagine a health system that goes beyond counting your steps and empowers you to stay healthy throughout your entire life. Slovenia's ground-breaking SLOfit programme is doing just that, and it's leading the way in lifelong fitness monitoring. This revolutionary approach not only tracks the nation's activity but also provides valuable scientific data that influences health policies across the country. We discuss SLOfit's impact with Gregor Starc, the programme's manager and a leading expert in fitness development. 

The World Health Organization (WHO) reports a concerning global decline in physical activity, with a staggering 1 in 4 adults worldwide and over 80% of adolescents failing to meet the recommended activity levels. This trend poses significant challenges to public health, impacting not only physical wellbeing but also mental health.

Even countries such as Slovenia—a country famed for having a 'sporting heart' and home to some of the world's top athletes—aren't immune to the decline in physical activity levels. The COVID-19 pandemic exacerbated this issue, as isolation measures limited opportunities for physical activity, especially for those with little or no access to green spaces and facilities. Reduced incomes and rising food insecurity due to the pandemic's economic fallout further contributed to a rise in childhood obesity, especially among already disadvantaged households.

But addressing declining rates of physical activity goes beyond individual responsibility. Governments, policymakers and communities must collaborate within key settings such as schools to create environments that foster and promote physical activity, particularly among the younger generation.

Data-driven solutions

Slovenia is taking proactive steps to address the decline in physical activity through innovative health management strategies such as SLOfit. This national programme, originally a classroom tool for physical education teachers, now promotes lifelong fitness for all Slovenians through student and adult programmes. SLOfit's mission is twofold: to raise awareness about healthy lifestyles for all ages and to improve access to online tools that promote sports and fitness monitoring. The programme now offers two options: SLOfit Students, designed for schools, and SLOfit Adults, which can be used in educational settings, sports clubs, workplaces, or even healthcare facilities.

Its SLOfit Students boasts over 330,000 young users, and goes beyond simply monitoring the physical development of children and young people. It emphasises the importance of regular exercise across all age groups and throughout the entire life cycle, adopting a holistic approach that tackles both individual behaviour and systemic factors. This provides a more significant and sustainable impact on public health and wellbeing.

Armed with data-driven insights, Slovenia's pioneering public health initiative, first established in the 1980s, offers a roadmap to combat inactivity. Unlike traditional programmes, SLOfit goes beyond numbers. It provides invaluable scientific evidence on physical activity directly to parents, policymakers, health institutes, and educators.

SLOfit: empowering individuals with information

The benefits of exercise are well documented: a stronger heart, a healthier body, and even a sharper mind. Physical activity helps to prevent and manage chronic diseases such as heart disease, cancer, and diabetes. Yet, despite these benefits, physical activity continues to decline worldwide.

"Think of us as powerful computers," says Gregor Starc, Head of the Laboratory for Diagnostics of Somatic and Motor Development at the Academic and Research Network of Slovenia, University of Ljubljana, Faculty of Sport, and the manager of SLOfit since 2007. "Our bodies are the hardware, and our brains are the software. Just like any computer, we need to keep our hardware in good shape to run complex programmes. Physical education is the only school subject that strengthens our bodies, so we are able to learn to our full potential."

Research has shown that Slovenia, alongside the Czech Republic, Slovakia, Denmark, Finland, Iceland, and Norway, have the fittest children and adolescents in Europe. In contrast, Southern European countries such as Spain, Italy and Greece (and the UK) have comparably lower levels of fitness. But why?

Slovenian children among fittest in Europe

Research has shown that Slovenia, alongside the Czech Republic, Slovakia, Denmark, Finland, Iceland, and Norway, have the fittest children and adolescents in Europe. In contrast, Southern European countries such as Spain, Italy and Greece (and the UK) have comparably lower levels of fitness. But why?

The answer could be shown by a recent decade-long research survey undertaken by SLOfit researchers. It revealed that Slovenian parents consistently rank physical education among the top four most important subjects for their children's development, alongside Slovenian, English and mathematics. This prioritisation stands in contrast to many countries where physical education often loses out to subjects considered as more 'academic'.

Moving beyond outdated fitness standards

One of the biggest challenges in promoting physical health is the reliance on outdated international fitness standards. These standards, often based on old data, may misclassify healthy children as overweight or obese. This can be particularly damaging for teenagers already dealing with the complexities of puberty, causing unnecessary anxiety about their bodies. These limitations arise when traditional measures such as Body Mass Index (BMI) don't consider factors such as gender, ethnicity or socioeconomic background, factors which can significantly impact physical development.

Providing personalised data

SLOfit provides a more accurate and empowering approach to physical development by providing personalised data throughout a user's lifespan. This information goes beyond outdated charts, fostering a collaborating environment where people of all ages can work with experts to achieve optimal health and wellbeing. Accessible through its website and the free My SLOfit app, users gain access to diagnostic tools, expert advice, and direct connection with fitness, education, and health professionals. This intergenerational approach is evident in programmes such as 'SLOfit Students' and 'SLOfit Adults', encouraging families to prioritise physical health together.

"Slovenians prioritise physical education because we [SLOfit] provide open communication about its impact on children's overall health and development", Starc continues. "This emphasis starts in schools, where teachers inform parents about the link between their child's motor skills and wellbeing."

Strong scientific evidence is crucial for putting effective policies in place. Such policies should aim to foster and advocate healthy living needs strong scientific evidence to underline its effects. After all, statistics are the backbone of policymaking. SLOfit data serves a vital role, acting as a roadmap for beneficial policies, especially in children's health. By harnessing the power of data, SLOfit tracks the implementation of policies and empowers citizens to make informed decisions about their physical activity.

My SLOfit app exemplifies SLOfit's data-driven approach. Testing is undertaken by qualified professionals, ensuring standardised data collection across schools. Results are entered into the app, checked with smart algorithms, analysed, and made available to users. The app even allows users to track their activity and health data beyond their school years, promoting lifelong healthy habits.

This data-driven approach empowers parents to understand their child's growth compared to norms, while also informing policy changes that prioritise daily physical activity for all children. For example, upon noticing concerning trends in children's physical activity, SLOfit researchers proactively advocated for evidence-based solutions, resulting in the 'Healthy Lifestyle' programme offering additional physical education hours for over 30,000 children.

"As storytellers of physical health, a key part of the SLOfit team's work is to make information relatable," says Starc. "People connect with narratives of why physical health is important, but when those stories are backed by data, they become even more impactful."

This is evident in how pediatricians use data to compare a child's growth to established norms, providing valuable insights to parents. This unique dataset empowers parents, while also informing policy changes that promote lifelong physical activity.

Given how limited communication between schools, physicians, municipalities and parents can be, SLOfit addresses this by creating a connected system. Through its website and free app 'My SLOfit,' SLOfit offers free fitness assessments and a platform for citizens to directly connect with fitness professionals, educators, and healthcare providers.

"SLOfit is a way of getting objective information and data on children's development," explains Starc. "Our main weapon is information. We give people feedback so they can see how they develop and make informed decisions about their physical activity and that of their children."

After all, seeing results is a powerful motivator when it comes to physical activity. "People can use this data to take decisions about their lives, about their physical activity, about whether they would like to improve something or not. It they don't see results, the motivational push disappears," says Starc.

Powerful citizen engagement

Having a culture of data-driven policy allows for parents, health professionals and key stakeholders such as school leadership representatives including teachers and students to come together and advocate for the health and wellbeing of children and adolescents. Slovenia's extensive childhood data infrastructure, combined with its close-knit population of around two million people, fuels powerful citizen engagement in SLOfit and facilitates direct access to decision-makers.

"Parents are our best allies in pushing the agenda for physical health forward. They are the ones helping us to put pressure on the decision-makers and the politicians," explains Starc.

SLOfit along with parents' association and paediatricians are currently advocating decision-makers and politicians to prioritise initiatives such as ensuring one hour of daily physical activity for all children aged 6 to 19 as part of the school curricula, as evident during a recent parliamentary discussion.

Bridging the inequality gap

This collaborative approach bridges inequality gaps too. When data from SLOfit revealed disparities in physical development between two merged schools, it prompted the mayor to address these imbalances and invest in improved facilities. This demonstrated the nation's commitment to equal opportunities for all, especially when it comes to children's health.

SLOfit is also a free service that democratises access to expert advice, ensuring that everyone, especially families in need of this support, can benefit from it without financial barriers.

"We are very sensitive to inequalities in Slovenia, it is ingrained in our mentality. We don't like to see inequality growing, particularly among children. While some argue competition fosters growth, Slovenians instinctively value a level playing field for all," explains Starc.

The ultimate goal? Not to raise elite athletes, but a healthier population overall. Slovenia's success demonstrates that promoting physical activity in nature, regardless of the weather, can also be a powerful tool.

"While we boast excellent sports infrastructure, including some of the best school facilities in the world, you might even mistake a rural school gym for an Olympic centre,  we recognise the importance of getting people outdoors. Slovenia is very, very green and our abundant natural beauty can allow us to break free from the comfort of indoor spaces. We encourage a shift towards embracing physical activity in nature, no matter the weather – after all, there's no such thing as bad weather, just bad clothing."

Our main weapon is information. We give people feedback so they can see how they develop and make informed decisions about their physical activity.

Empowering policy and individual action

While SLOfit may not directly influence physical activity levels, it indirectly empowers people to make informed choices. Parents gain valuable insights into their child's development, allowing them to encourage healthy habits from a young age. This data-driven approach also informs policymakers at local and national levels, enabling them to create evidence-based policies that prioritise physical education and extracurricular activities within school curricula. By equipping policymakers with the right information, SLOfit empowers them to create opportunities for children to be active and thrive.

"Imposing policies can breed resentment," Starc explains. "Instead, we prioritise collaboration through a bottom-up approach, empowering schools and specialists to drive change at the local level. Through open communication with the parents, teachers and paediatricians, we share knowledge and build trust. This paves the way for stronger partnerships, making future policy changes that encourage collaboration seem less like mandates and more like natural extensions of existing efforts. Yes, progress is gradual, but it's undeniable – positive change is underway."

Think of us as powerful computers. Our bodies are the hardware, and our brains are the software. Just like any computer, we need to keep our hardware in good shape to run complex programmes. Physical education is the only school subject that strengthens our bodies, so we are able to learn to our full potential. 

Embracing technology for a healthier future

Artificial intelligence systems (AI systems) are revolutionising health, and SLOfit has been at the forefront of AI systems since 2018. Collaborating with Slovenia's leading AI institute, the Jožef Stefan Institute, SLOfit developed tools such as models for children's height prediction for parents, ensuring accessibility by keeping the service free.

Looking ahead, SLOfit plans to integrate the system into wearable technology such as smartphones and smartwatches. This integration will allow parents to upload data and receive personalised feedback on their child's development. Ultimately, SLOfit aims to empower parents and children to make healthy choices, contributing to better physical and mental health for all.

The future of fitness: learning from SLOfit

Other countries can learn a valuable lesson from Slovenia: regularly collect data on children's health to encourage better choices by society and governments. Outdated research can't keep pace with rapid changes in technology, health behaviours, and children's schedules.

SLOfit's success highlights this. Over 10 years, the researchers from SLOfit observed screen time double, while moderate physical activity declined. These findings spurred parents and policymakers to make changes to improve children's health. "You cannot rely on old data, you have to constantly monitor what's going on and this is a valuable lesson," states Starc.

Despite reservations of data collection in some countries, Slovenia proves ethical implementation is achievable. Collaboration is key. Countries such as Portugal, through their ‘FITescola’, and Hungary, through their 'NetFit', are implementing similar programmes, and Slovenia is already working with Japan and researchers from other countries such as Scotland, Wales and France to share their knowledge.

"We are talking to many countries, they want to learn from our experiences but of course we tell them it's not as easy as just having a test battery. There are many factors to it, like educating teachers, so that something like SLOfit can be introduced into the curriculum. You have to do many steps before a system such as this can be effective. But it can be done, we've proven it."

Why education is important in promoting health

If you would like to learn more about the importance of health in education in promoting health, discover the  Schools4Health initative which aims to make every school a health promoting school that prioritises the health of everyone in the school community. The project also aims to will integrate health, education, social and climate goals to achieve a ‘triple-win’ for school communities through positive educational academic outcomes, sustainable environments and health equity.

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